International Confederation of Midwives

Insufficient progress has been made to reduce morbidity and mortality for women, children and adolescents particularly in Humanitarian and Fragile settings (HFS). Midwives play a critical and unique role in ensuring communities receive quality and safe essential sexual, reproductive, maternal, newborn, child, and adolescent health services. A lack of knowledge exists on the availability and experiences of midwifery services in HFS. This manuscript provides an overview of the midwifery density in HFS and a synthesis of the experiences of women receiving midwifery care, and barriers and facilitators for midwives providing essential SRMNCAH services in HFS. Guided by an expert committee, a concurrent mixed methods approach was applied, using secondary analysis of primary quantitative and qualitative data sources. Quantitative analysis of the global distribution of midwives compared to fragility was undertaken. Qualitative analysis of experiences of receipt and provision of midwifery care was undertaken across four settings providing humanitarian care. There is a critically low density of midwives in humanitarian and fragile settings. Sub-Saharan Africa accounts for the highest levels of fragility yet lowest density of midwives able to provide SRMNCAH services. Lack of finances both constrains midwives from effectively providing services and prevent communities from utilising services. Sub-optimal working conditions through rising workloads, insufficient and/or inconsistent resources were frequently reported to impede midwives from providing care in HFS. Uniquely for HFS, threats to the safety and security of midwives to conduct their work was widely reported. Key facilitators identified included, complex adaptive health system designs to respond effectively to the rapidly changing HFS environment, realisation of supporting "power, agency and status" as instrumental for midwives to provide quality care and promotion of community-centric approaches may enable continuity of care and uptake of essential SRMNCAH services. Midwives are critical to protect the health and well-being of communities. They require urgent protection and prioritisation in HFS areas where the need is greatest.

The film Don’t Look Up, examines what it will take to get world leaders and the public to be proactive about a comet that is on a collision course with earth. We argue that the same attitude of self-interested denialism is stopping crucial action being taken when it comes to supporting midwifery models of care to address the current problems in maternity care.

SynopsisFIGO and the International Confederation of Midwives produced two joint statements endorsing WHO guidelines on prevention and treatment of postpartum hemorrhage.

We searched guideline databases and websites of professional associations and international organizations working on sexual and reproductive health; We looked for guidelines, protocols, consensus statements and practice recommendations on management of pregnant women with COVID-19. Additionally, we searched: MEDLINE, EMBASE and Google Scholar. Data extraction was done by two independent reviewers using a customized tool that was developed to record the key information relevant to the review question. The difference between the two authors on data extraction was resolved by discussion.

Content ExtRactor and MINEr

Content ExtRactor and MINEr